Individual
RUDY DELEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
526 SHOUP AVE W STE K, TWIN FALLS, ID 83301-5050
(208) 734-7373
Mailing address
679 SUN TERRACE DR, TWIN FALLS, ID 83301-8934
(208) 308-6992
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6544
ID
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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